Authors (including presenting author) :
Tong WS(1), Li MY(1), Tse YY(1), Wong TT(1), Yeung PS(1), Lau SY(1)
Affiliation :
Department of Surgery, United Christian Hospital
Introduction :
In 2015, Department of Surgery conducted a retrospective documentation survey on pain assessment by nurses. 192 patient documents from surgical patients were reviewed by random and only 50% of pain assessments were well documented, while 62.5% of these patients reported with moderate or severe pain during hospitalization. Moreover, there were no related guidelines available in the Department. Guidelines on pain assessment and management has been developed by the Pain Management Workgroup and used in the surgical department, UCH since 2015. Clinical guidelines are an increasing familiar part of clinical practice (Woolf et.al., 1999).
Objectives :
1. To standardize pain assessment and management with implementation of guidelines in surgical wards
2. To promote effective pain assessment and multidisciplinary pain management among surgical nurses
3. To maintain standards of pain assessment and management through audits 4. To evaluate the effectiveness for the implementation of guidelines on pain assessment and management
Methodology :
Regular audits were performed in April, 2016 and August 2017 to evaluate the compliance rate on guidelines in pain assessment and management. Documentation of pain score and related pain management would be retrieved from the medical records.
Result & Outcome :
In 2016, 40 randomized surgical cases reviewed (10 for each surgical ward), 100% of the case nurses assess patients’ existence of pain, 92.5% pain score were documented on the observation chart or progress sheet. Regular pain assessment was conducted according to the Guidelines on Pain Assessment for Nurses in Surgery, UCH. The overall compliance rate to pain assessment guidelines is 95.8%. For the pain management guidelines, the overall compliance rate is 93.9%. 97.5% nurses administered analgesics to patient with pain score ≥4 or moderate to severe pain, with 95% nurses performed pain assessment before administering analgesia. 95% of these patients received regular analgesics in post-operatively Day 0 to Day 1. 80% of these patients were educated on pain relief treatment and the possible outcome. 90% nurses observed, documented and reported the responses of patients to the intervention and care given. There was further increase in compliance on Guidelines on Pain Assessment and Management among nurses in 2017. The overall compliance rate on Guidelines in Pain Assessment is 98.9% comparing with 95.8% in 2016. And the overall compliance rate on Guidelines in Pain Management is 99.2% comparing with 93.9% in 2016.
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